New Patient Forms
New Patient Checklist
If you would like to establish your child at our practice, please email or fax a copy of their shot record along with the insurance card. Please include your name and contact number. (email & fax number below)
Once you are made an appointment your new patient forms will be text to you through Phreesia. There is no need to fill out prior.
If you do not have a number we can text to please complete the forms listed below, you will need Adobe Reader.
Download Adobe Reader for free. We do not accept transferred records on CD's.
Remember paperwork must have an original signature by parent or Legal Guardian in order for us to process. We cannot accept computer generated signatures. Please make sure to ATTACH (no camera pictures) any forms and email to
aaldama@cactuschildrens.com or
fax to 602-938-2198.
Please request previous office to print out and mail or download and bring a copy to our office.
What's New?


